| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SETH MAJOR3 | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 51106 | DELTA DENTAL OF SOUTH DAKOTA | $3K | — | $3K | 1.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES | 4200 CORPORATE DR, STE 160 WEST DES MOINES, IA 50266 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 6.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2850 W GOLF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.34% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $35 | $3K | 6.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES | P.O. BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $81 | $2K | 4.14% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $553 | $95 | $648 | 1.53% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $466 | $93 | $559 | 1.32% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.14% |
| GARY L HOLTROP3 | P.O. BOX 218 IRETON, IA 51027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.12% |
| JON SCOTT SWARTZENDRUBER3 | 600 HWY 169 SOUTH MINNEAPOLIS, MN 55426 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 51106 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.07% |
| SELECT NETWORKS3 | 317 6TH AVENUE DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 8.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ST LUKES REGIONAL MEDICAL CENTER | Direct payment from the plan Service code 50 | 2720 STONE PARK BLVD SIOUX CITY, IA 51104 | $208K |
| MERCY MEDICAL CENTER SIOUX CITY | Direct payment from the plan Service code 50 | 801 5TH ST PO BOX 3168 SIOUX CITY, IA 51104 | $171K |
| HYVEE PHARMACY SOLUTIONS | Direct payment from the plan Service code 50 | 10004 S 152ND ST STE C OMAHA, NE 68138 | $121K |
| CAREMARK SPECIALTY P | Direct payment from the plan Service code 50 | 11162 RENNER BLVD LENEXA, KS 66219 | $119K |
| CVS SPECIALTY 02921 | Direct payment from the plan Service code 50 | 105 MALL BLVD MONROEVILLE, PA 15146 | $103K |
| SIOUXLAND SURGERY CENTER LTD | Direct payment from the plan Service code 50 | 600 N SIOUX POINT RD DAKOTA DUNES, SD 57049 | $87K |
| DUNES FAMILY PHARMACY | Direct payment from the plan Service code 50 | 101 TOWER RD STE 130 DAKOTA DUNES, SD 57049 | $67K |
| GREGORY D NADEN MD | Direct payment from the plan Service code 50 | 230 NEBRASKA ST SIOUX CITY, IA 51101 | $45K |
| WALMART PHARMACY 101332 | Direct payment from the plan Service code 50 | 1601 CORNHUSKERS DR S SIOUX CITY, NE 68776 | $29K |
| WALMART PHARMACY 103590 | Direct payment from the plan Service code 50 | 3101 FLOYD BLVD SIOUX CITY, IA 51108 | $29K |
| MAYO CLINIC HOSPITAL ROCHESTER | Direct payment from the plan Service code 50 | 1216 2ND ST SW ROCHESTER, MN 55902 | $23K |
| PHARMACARE SPECIALTY PHARMACY 00102 | Direct payment from the plan Service code 50 | 1604 E 17TH AVE DENVER, CO 80218 | $23K |
| HY VEE PHARMACY 1610 | Direct payment from the plan Service code 50 | 2827 HAMILTON BLVD SIOUX CITY, IA 51104 | $22K |
| WALGREENS 10502 | Direct payment from the plan Service code 50 | 1030 W 21ST ST S SIOUX CITY, SD 68776 | $20K |
| ANN E REHAN MD | Direct payment from the plan Service code 50 | 1125 PIERCE ST SIOUX CITY, IA 51105 | $15K |
| CVS CAREMARK | Direct payment from the plan Service code 50 | 11162 RENNER BLVD LENEXA, KS 66219 | $15K |
| THOMAS J KENNY IV MD | Direct payment from the plan Service code 50 | 101 TOWER RD STE 120 DAKOTA DUNES, SD 57049 | $14K |
| TAUHNI T HUNT MD | Direct payment from the plan Service code 50 | 2730 PIERCE ST STE 201 SIOUX CITY, IA 51104 | $13K |
| JON M GRUDEM MD EMPLOYER | Direct payment from the plan Service code 50 | 4802 SUNNYBROOK DR SIOUX CITY, IA 51106 | $13K |
| AMANDA R DANNENBRING DO | Direct payment from the plan Service code 50 | 345 W STEAMBOAT DR STE 300 DAKOTA DUNES, SD 57049 | $13K |
| PIERCE STREET SAME DAY SURGERY | Direct payment from the plan Service code 50 | 2730 PIERCE ST STE 100 SIOUX CITY, IA 51104 | $12K |
| ADNAN A QALBANI MD | Direct payment from the plan Service code 50 | 330 DAKOTA DUNES BLVD 200 DAKOTA DUNES, SD 57049 | $12K |
| KATHLEEN M LAFAVOR DO | Direct payment from the plan Service code 50 | 1000 JACKSON ST SIOUX CITY, IA 51105 | $11K |
| CHILDREN'S HOSPITAL AND MEDICAL | Direct payment from the plan Service code 50 | PO BOX 247036 OMAHA, NE 68124 | $10K |
| RIVERVIEW SURGICAL CENTER | Direct payment from the plan Service code 50 | 201 E 4TH ST S SIOUX CITY, NE 68776 | $10K |
| LEEDS PHARMACY INC | Direct payment from the plan Service code 50 | 2729 OUTER DRIVE SIOUX CITY, IA 51104 | $10K |
| HENDRIK B KLOPPER MD EMPLOYER | Direct payment from the plan Service code 50 | 575 N SIOUX POINT RD DAKOTA DUNES, SD 57049 | $10K |
| INDERJIT S CHABRA MD | Direct payment from the plan Service code 50 | 801 5TH ST SIOUX CITY, IA 51105 | $10K |
| ANGELA J ALDRICH MD | Direct payment from the plan Service code 50 | 2730 PIERCE ST STE 201 SIOUX CITY, IA 51104 | $10K |
| WILLIAM J ANDREWS MD EMPLOYER | Direct payment from the plan Service code 50 | 4802 SUNNYBROOK DR SIOUX CITY, IA 51106 | $10K |
| SANFORD USD MEDICAL CENTER | Direct payment from the plan Service code 50 | 1305 W 18TH ST SIOUX FALLS, SD 57105 | $10K |
| MAYO CLINIC | Direct payment from the plan Service code 50 | 200 1ST ST SW ROCHESTER, MN 55905 | $10K |
| DIABETES SUPPLY CENTER | Direct payment from the plan Service code 50 | 2910 S 84TH ST OMAHA, NE 68124 | $9K |
| STEVEN J FERGUSON OD | Direct payment from the plan Service code 50 | 305 DAKOTA DUNES BLVD DAKOTA DUNES, SD 57049 | $9K |
| WALGREENS 15647 | Direct payment from the plan Service code 50 | 1900 HAMILTON BLVD SIOUX CITY, IA 51104 | $9K |
| LISA A REMER GILLETT MD | Direct payment from the plan Service code 50 | 345 W STEAMBOAT DR STE 300 DAKOTA DUNES, SD 57049 | $8K |
| NANCY P SCHENK MD | Direct payment from the plan Service code 50 | 345 W STEAMBOAT DR STE 300 DAKOTA DUNES, SD 57049 | $8K |
| WADE K JENSEN MD EMPLOYER | Direct payment from the plan Service code 50 | 4802 SUNNYBROOK DR SIOUX CITY, IA 51106 | $8K |
| ELIZABETH M AUGUSTINE HARTMAN MD EMPLOYER | Direct payment from the plan Service code 50 | 575 SIOUX POINT RD DAKOTA DUNES, SD 57049 | $8K |
| ORTHO NEBRASKA HOSPITAL | Direct payment from the plan Service code 50 | PO BOX 30155 OMAHA, NE 68103 | $7K |
| DRILLING PHARMACY | Direct payment from the plan Service code 50 | 4010 MORNINGSIDE AVE SIOUX CITY, IA 51106 | $7K |
| KEVIN W HAMBURGER MD | Direct payment from the plan Service code 50 | 1000 JACKSON ST SIOUX CITY, IA 51105 | $6K |
| QUENTIN J DURWARD MD EMPLOYER | Direct payment from the plan Service code 50 | 575 N SIOUX POINT RD DAKOTA DUNES, SD 57049 | $6K |
| SUSAN M CALDWELL MD | Direct payment from the plan Service code 50 | 1125 PIERCE ST SIOUX CITY, IA 51105 | $6K |
| GREENVILLE PHARMACY | Direct payment from the plan Service code 50 | 2705 CORRECTIONVILLE RD SIOUX CITY, IA 51105 | $6K |
| WALGREENS 05470 | Direct payment from the plan Service code 50 | 4650 MORNINGSIDE AVE SIOUX CITY, IA 51106 | $6K |
| MICHAEL A O'NEAL OD | Direct payment from the plan Service code 50 | 305 DAKOTA DUNES BLVD DAKOTA DUNES, SD 57049 | $6K |
| PAUL D PETERSON DO | Direct payment from the plan Service code 50 | 2600 OUTER DR N SIOUX CITY, IA 51104 | $6K |
| HY VEE PHARMACY 1614 | Direct payment from the plan Service code 50 | 4500 SERGEANT RD SIOUX CITY, IA 51106 | $6K |
| FAMILY HEALTH CARE OF SIOUXLAND | Direct payment from the plan Service code 50 | 814 PIERCE ST STE 300 SIOUX CITY, IA 51101 | $5K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 222 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA | 184 | $2.3M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 530 | $220K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 348 | $32K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $167K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $167K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $125K |
| Stop-loss / reinsurancereinsurance | WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA | 184 | $2.2M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 530 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.